Surgical Treatment of Specific War Injuries
Strategies for Damage Control in Pelvic Trauma
Emergent treatment of severe pelvic trauma is built on three mainstays. Initially, treatment of hemorrhagic shock and emergent bony stabilization are in the foregroung. Transfusion, fracture stabilization using circumferential pelvic antishock sheeting, external fixation of pelvic clamping, as well as operative of angiographic hemorrhage control are first line measures. Prophylaxis of sepsis is the second mainstay, including radical wound debridement, early internal fixation, fecal diversion or suture of intraperitoneal bladder rupture, Finally, peripelvic associated injuries need to be addressed. In the emergent situation, measures such as suprapubic cystostomy, reconstruction of the pelvic floor, suture of an extraperitoneal bladder rupture, wound debridement or fecal diversion need to be considered.